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Adler and Addiction treatment

A common theme that seems to run through many addicts stories is that of feeling isolated and "worth less than". Initially the drugs help to make the user feel accepted and confident. For many people they grow out of this, but addicts develop a dependence on the substance and the cycle of addiction begins. Let's take a look at an addiction recovery program from the perspective of a theorist who emphasised this social aspect of the human experience."

Alfred Adler was a therapist active at the same time as Sigmund Freud. They worked closely together for 8 years, but they eventually parted ways as their theories were incompatible. Freud believed that humans were victims of their childhood and governed by uncontrollable forces. Adler disagreed and said that although we are products of our childhood we are able to change our perception of childhood and become free to live our life in a way that is healthy and productive.

Part of Adler's theory rested on his belief that childhood instils in us a natural sense of inferiority. As a child we discover our physical limitations and find that compared to adults we are quite weak. Adler said that this feeling of inferiority was both normal and healthy. He said that it generated in humans the need to overcome our deficiencies and excel. This inferiority could be linked to the sense of "not belonging" that so many addicts report.

Adler was the first theorist to openly embrace the broader context that the person lives in and claimed that our social context plays an important role in how we behave. He also placed emphasis on the subjective experiences of the client. Adlerian therapists place emphasis on understanding the clients interpretation of events rather than on the event itself.

A persons lifestyle is defined in Adlerian theory as being the manner in which a person organizes his or her reality. It describes how we understand reality and how we adapt ourselves to fit that reality. It includes the sum of our perceptions, knowledge, and values.

Adler included social functioning as a barometer of mental health. He said that for a human to take interest in helping his fellows demonstrated social interest which aided a sense of belonging and contributing. There is an African saying that can be translated as "A human is a human through his relationship with other humans". This social connectedness, or community feeling, is an important part of an Adlerian concept of health. We seek a place in society where we are loved and valued. If we do not find it then we become discouraged and unable to function to our full capacity.

Our first social environment is usually our family. Adler theorized that our perceived position in the family sets us up to play out patterns of interaction in later life. This perceived position may be given to us by our birth order.

The goals of Adlerian treatment are to:

Foster social interest

Help clients overcome discouragement and inferiority

Modify the clients lifestyle

Change faulty motivation

Help clients feel valued and part of society

Help clients rejoin society as contributing members

This may seem strikingly similar to the goals of an addiction recovery center.

By helping an addict to examine her faulty thinking the therapist can help to reframe past events in such a way as to change perception. It is our perception that informs how we feel about the event and this in turn informs our behaviour. In many ways we set ourselves up through this faulty private logic. For example consider the following thinking that an addict may have:

"I am basically unloveable"

"The world is filled with people who are likely to reject me if I reach out"

"Therefore I should use drugs to numb the feeling of seperateness and to avoid taking the risk of forming friendships"

This sort of thinking has two faulty premises that inform the conclusion. An Adlerian therapist will help the client to examine these core beliefs and find ways to reframe the experiences that inform them.

As a side effect of joining a therapeutic community in drug rehab the addict may discover a fresh sense of self. Many clients express a great sense of relief when joining a 12 step program - we often hear them say "finally I have found a place where I belong". From an Adlerian perspective this could help to challenge the faulty logic that informs drug taking behaviour. It will also help to ease the sense of discouragement that addicts feel towards life.

One of the premises of a therapeutic community is the idea that each member must look out for the other members. This is often made explicit in contracts or preambles read out before group therapy. From an Adlerian perspective one could interpret this as being an attempt to foster social interest in the group members. Drug addiction leads to very self-centered thought and behaviour. The obsession to use and consume drugs does not leave much space for consideration of other people. By encouraging clients to take an active interest in one another the therapeutic program is teaching them to take social interest, which Adler defines as a very important part of mental health.

Remember that Adler has a different definition of lifestyle from the usual meaning of the word. A drug rehab program will seek to alter the way clients approach life. It will seek to replace unhealthy beliefs and attitudes with more socially useful values. Faulty logic that leads to incorrect assessment of situations and inappropriate behaviour will be challenged. Addiction recovery from an Adlerian perspective will only be possible if the addict learns a new way of going about life.

Rejoining society can be daunting for addicts leaving a drug treatment center. Not only have they been physically isolated from society but they may have a slew of consequences to face up to. The 12 step program addresses these consequences in a logical fashion. From an Adlerian perspective steps 8 and 9 help the addict to once again feel valued. Where once they created damage to society they are now repairing and rebuilding that damage. A drug rehab treatment program should be provided on a continuum of care. At the later phases of treatment the addict will start to explore his/her role in society and start to take certain responsibilities in that society.